Suplementação de zinco e seu potencial terapêutico e profilático na incidência de distúrbios do paladar e mucosite em pacientes em tratamento quimioterápico: uma revisão sistemática

Abstract

Introduction: Chemotherapy is one of the most used treatments in oncology. By having a systemic approach, chemotherapy acts not only on tumor cells, but also on healthy cells, and may cause adverse effects, such as changes in the oral mucosa and taste, which can lead to a decrease in the daily intake of nutrients, contributing to the decline nutritional status, worsening quality of life and risk of interruptions in treatment. Zinc supplementation is one of the therapeutic options that have been studied as a prophylaxis and treatment of mucositis and taste disorders. Objective: To evaluate the therapeutic and prophylactic potential of zinc supplementation in mucositis and taste disorders in patients undergoing chemotherapy. Methodology: Systematic Review (SR) of Randomized Clinical Trials (RCTs) that evaluated the effect of zinc supplementation in patients ≥18 years old, undergoing chemotherapy treatment, considering the outcomes: mucositis and taste disorders. Articles were searched in electronic databases: MEDLINE, EMBASE, CENTRAL, LILACS and Web of Science. The selection of studies was carried out with the aid of a reference manager software and the methodological quality assessment process was carried out using a risk of bias assessment tool recommended by Cochrane, both processes being carried out independently by three reviewers. Results: 322 studies were found in the initial search, which resulted in 3 eligible RCTs, totaling 313 patients. There was great heterogeneity regarding the sample of participants, intervention (dosage and duration) and outcome assessment tools. The studies used 2 to 3 zinc sulfate capsules of 220mg a day, with different periods and fractions. In one of the studies, the placebo used was a multivitamin, while in the other two, capsules without pharmacological properties. In general, a tendency of zinc sulfate to reduce the incidence and severity of oral mucositis in patients during chemotherapy was observed, however only one study confirmed the hypothesis that supplementation prevents the incidence of mucositis (p<0.05). Conclusion: Although there is a tendency for zinc sulfate to reduce the incidence of mucositis, there is not enough evidence to confirm its use, as well as its dosage.